Research Article
Factors Predicting Self-Care Behaviors among Low Health
Literacy Hypertensive Patients Based on Health Belief Model in
Bushehr District, South of Iran
Azam Larki,
1
Rahim Tahmasebi,
2
and Mahnoush Reisi
1
1
Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
2
Department of Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
Correspondence should be addressed to Mahnoush Reisi; reisi mr@yahoo.com
Received 30 November 2017; Accepted 18 January 2018; Published 13 February 2018
Academic Editor: Andrea M. P. Romani
Copyright © 2018 Azam Larki et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Te aim of this study was to determine the factors infuencing adherence to self-care behaviors among low health literacy hyperten-
sive patients based on health belief model. A cross-sectional study was conducted among 152 hypertensive patients with low health
literacy. Patients with limited health literacy were identifed by S-TOFHLA. Te data were collected using H-scale for assessing self-
care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher-made questionnaire was applied for collecting
data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses.
Perceived self-efcacy was associated with all self-care behaviors except medication regimens. Tere was a signifcant association
between perceived susceptibility and adherence to both low-salt diet (OR = 3.47) and nonsmoking behavior (OR = 1.10). Individuals
who had more perceived severity (OR = 1.82) had signifcantly greater adherence to their medication regimens. Perceived benefts
and barriers were not signifcantly associated with either type of hypertension self-care behaviors. It seems that designing and
implementation of educational programs to increase self-efcacy of patients and promote their beliefs about perceived susceptibility
and severity of complications may improve self-care behaviors among low health literacy hypertensive patients.
1. Introduction
Hypertension is an important worldwide public-health chal-
lenge, which can lead to very serious consequences such as
cardiovascular and kidney disease [1]. According to reports,
more than one in three adults worldwide sufer from high
blood pressure, and this proportion increases with age [2].
Due to the high prevalence of hypertension and its seri-
ous complications, the World Health Organization (WHO)
assigned the theme of World Health Day 2013 to hypertension
as a “silent killer, global public-health crisis” [3]. Statistics
showed an increase in the prevalence of hypertension. Te
number of patients with hypertension has increased from 600
million cases in 1980 to 1 billion in 2008; over 40 percent
of adults were known to have hypertension [4]. Also, it was
predicted that, by 2025, 1.56 billion adults will sufer from
hypertension [5]. In this regard, it was reported to be 14 to
34 percent hypertensive patients in Iran [6].
Although this disease can lead to acute and debilitating
complications and imposes many costs on the individual
and the healthcare system, studies show that blood pressure
control in hypertensive patients is not desirable, as the
results of various studies all over the world suggest a high
prevalence of uncontrolled blood pressure among people
with hypertension [7, 8].
Te most important strategy for controlling blood pres-
sure and maintaining it in the optimal range is patient
compliance with self-care behaviors [9]. Te fndings of
a meta-analysis that examined the results of 87 studies
indicated that optimal self-care in hypertensive patients
could reduce systolic and diastolic blood pressure by 5
and 4.3 mmHg, respectively [10]. Self-care for people with
high blood pressure includes compliance with a healthy
diet (especially low salt), physical activity, nonsmoking,
abstaining from alcohol, weight management, and following
prescribed medications [11]. Despite the necessity of carrying
Hindawi
International Journal of Hypertension
Volume 2018, Article ID 9752736, 7 pages
https://doi.org/10.1155/2018/9752736